Kristin Marie Palen, OTR/L

Individual provider Active NPI Pediatric Occupational Therapist · Barco, NC

NPI 1417122136 · NPPES record last updated Feb 8, 2021

Key facts

NPI
1417122136
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Occupational Therapist 225XP0200X
License
5339 (NC)
Practice address
4130 Caratoke Hwy FL 1
Barco, NC 27917-8001
Phone
(252) 621-3507
NPI assigned
Apr 23, 2008
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
5339NCMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Connections Pediatric Therapy, LLC Pediatrics Current
since Feb 14, 2021
Accepting new patients
Blue Ridge Speech & Hearing Center of Loudoun County, Inc. Past Accepting new patients

Locations

4130 Caratoke Hwy
Fl 1
Barco, NC 27917
Phone (252) 621-3507

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7509/brand/1/csg/1/fhir/r4

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 0119004155 VA
Pediatric Occupational Therapist 225XP0200X 5339 NC Yes

Addresses

Primary practice location

4130 Caratoke Hwy FL 1
Barco, NC 27917-8001

Mailing address

4130 Caratoke Hwy FL 1
Barco, NC 27917-8001
Phone (252) 621-3507

Other providers in Barco, NC

All providers in Barco, NC · Pediatric Occupational Therapist in North Carolina

Sources for this page

Verify at the official NPI Registry.